Xu Yajun, Da Bu, Zhao Fengxia, Gao Mingjuan, Xue Lihua, Zheng Hao, Shi Hongzhi, Hou Lihua, Miao Shan, Liu Xinwei, Wang Yajing, Xu Hong
Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China.
Department of General Surgery, The Third Medical Center, Chinese PLA General Hospital, Beijing, China.
Front Med (Lausanne). 2023 Apr 6;10:1156628. doi: 10.3389/fmed.2023.1156628. eCollection 2023.
Plasma cell mastitis (PCM) is a complex breast disease in the clinic. Currently, there are no unified diagnostic criteria for the disease and no standard treatment methods. The effects of hormone, Conventional Chinese medicine and other treatments are uncertain, with long treatment duration and notable side effects. Surgery is the preferred treatment, but the recurrence rate after conventional surgery is very high, which may be related to depression of the nipple. This study aimed to evaluate the efficacy of a novel corrective procedure in patients with cellular mastitis and depressed nipples.
Patients with PCM who received surgical treatment in the Third Medical Center of PLA General Hospital from January 1996 to January 2018 were retrospectively analyzed. According to the presence or absence of nipple depression before surgery, the patients were divided into the nipple depression group and the non-nipple depression group. In the nipple depression group, patients were subdivided into a novel corrective surgery group ("one" suture or half pocket suture) and a conventional corrective surgery group (oil yarn traction valgus correction of nipple depression). Demographic, clinical, therapeutic, and postoperative relapse data were collected and analyzed.
Compared with the patients in the non-nipple depression group, patients in the nipple depression group had a significantly higher recurrence risk after surgery (HR = 2.129 95% CI: 1.110-4.083, = 0.023). Patients who underwent novel corrective surgery had a significantly lower recurrence risk than those who underwent conventional corrective surgery (HR = 0.363 95% CI: 0.150-0.880, = 0.025). In addition, the novel corrective surgery significantly reduced the postoperative recurrence risk (HR = 0.088 95% CI: 0.009-0.886, = 0.037).
How to correct nipple depression is a critical factor for postoperative recurrence of PCM, and this novel corrective surgery for nipple depression can effectively reduce the postoperative recurrence rate in patients with nipple depression.
浆细胞性乳腺炎（PCM）是临床上一种复杂的乳腺疾病。目前，该病尚无统一的诊断标准，也没有标准的治疗方法。激素、中药等治疗效果不确切，治疗周期长且副作用明显。手术是首选治疗方法，但传统手术后复发率很高，这可能与乳头凹陷有关。本研究旨在评估一种新型矫正手术治疗细胞性乳腺炎合并乳头凹陷患者的疗效。
回顾性分析1996年1月至2018年1月在中国人民解放军总医院第三医学中心接受手术治疗的PCM患者。根据术前是否存在乳头凹陷，将患者分为乳头凹陷组和非乳头凹陷组。在乳头凹陷组中，患者又细分为新型矫正手术组（“一”字缝合法或半荷包缝合法）和传统矫正手术组（油纱牵引乳头凹陷外翻矫正术）。收集并分析人口统计学、临床、治疗及术后复发数据。
与非乳头凹陷组患者相比，乳头凹陷组患者术后复发风险显著更高（HR = 2.129，95%CI：1.110 - 4.083，P = 0.023）。接受新型矫正手术的患者复发风险显著低于接受传统矫正手术的患者（HR = 0.363，95%CI：0.150 - 0.880，P = 0.025）。此外，新型矫正手术显著降低了术后复发风险（HR = 0.088，95%CI：0.009 - 0.886，P = 0.037）。
如何矫正乳头凹陷是PCM术后复发的关键因素，这种新型乳头凹陷矫正手术可有效降低乳头凹陷患者的术后复发率。
